Welfare for the Elderly Seminar

Stomach and Intestinal Diseases: How to recognise themDr Kalpesh Besherdas

Consultant Gastroenterologist, Barnet & Chase Farm Hospital

Sunday 12 February, 3.30 – 5.00pm

BAPS Shri Swaminarayan Mandir, Neasden

What to worry about most?

What to worry about most?

• Bowel cancer

• Oesophageal and stomach cancer

• Pancreatic cancer

• Liver cancer

2003 Estimated US Cancer Cases*

ONS=Other nervous system.*Excludes basal and squamous cell skin cancers and in situ carcinomas except urinary bladder.Source: American Cancer Society, 2003.

Men675,300

Women658,800 210,816 Breast

79,056 Lung/bronchus

72,468 Colon & rectum

39,528 Uterine corpus

26,352 Ovary

26,352 Non-Hodgkin lymphoma

19,764 Melanoma of skin

19,764 Thyroid

13,176 Pancreas

13,176 Urinary bladder

62,238 All other sites

Prostate 222,849

Lung/bronchus 94,542

Colon/rectum 74,283

Urinary bladder 40,518

Melanoma of 27,012skin

Non-Hodgkin 27,012lymphoma

Kidney 20,259

Oral cavity 20,259

Leukemia 20,259

Pancreas 13,506

All other sites 114,801

Men675,300

Women658,800

How Does Colorectal Cancer Develop?

Colon Polyp

Colon Cancer

Symptoms of Colorectal Cancer

Time Course Symptoms Findings

Early None None

Occult blood in stool

Mid Rectal bleeding

Change in bowel habits

Rectal mass

Blood in stool

Late Fatigue

Anemia

Abdominal pain

Weight loss

Abdominal mass

Bowel obstruction

Bowel cancer: how to recognise it

•Rectal bleeding with change of bowel habit of ≥ 3 weeks duration

•Rectal bleeding without change in bowel habit with no obvious cause ≥ 3 weeks duration

•Change of bowel habit persisting for 3 weeks or more without bleeding

•Abdominal mass thought to be large bowel cancer

•Anaemia : fatigue

Is Colorectal Cancer Preventable?

YES!

• Screening

The Programme

Eligibility

Men and Women aged 60-69, and registered with a GP will automatically be invited to participate and offered a FOB test kit every two years

Those aged 70 and over are not invited automatically but are able to request a test kit from the Hub

THE KIT

Colonoscopy

CT Colography

Colon Polyp

CT Colography

Colon Polyp

CT ColographyColon Cancer

Rectal Bleeding

•If you’ve had blood in your poo or looser poo for 3 weeks, your doctor wants to know.

•Chances are it’s nothing to worry about, but these symptoms could be signs of bowel cancer, so tell your doctor. Finding bowel cancer early makes it more treatable and could save your life.

Upper GI cancer

Oesophageal/Stomach cancer

•Indigestion or heartburn that doesn’t go away

•Not feeling hungry (loss of appetite)

•Bloating after a small amount of food

•Nausea and vomiting

•Difficulty in Swallowing

•Feeling very tired and lethargic (symptom of anaemia)

•Unexplained weight loss

•Blood in your vomit or faeces or black tar like faeces.

Oesophageal/Stomach cancer causes

• Obesity or a poor diet, particularly one which contains a lot of salty, pickled or processed foods

• Infection with an organism called Helicobacter pylori• Barrett's oesophagus (where abnormal cells develop in the lining of

the lower oesophagus)• Pernicious anaemia (an autoimmune condition where the lining of

the stomach becomes thin, less acid is produced and anaemia develops due to lack of vitamin B12), atrophic gastritis or a hereditary condition of growths in the stomach

• Smoking• Previous surgery for peptic ulcer

Diagnosing stomach cancer

• Endoscopy

• Barium X-ray

• CT scan

Abdominal pain

Diarrhoea

Common causes of constipation

• not enough fibre in the diet• not drinking enough water• lack of exercise• Medications• irritable bowel syndrome• changes in life or routine such as pregnancy,

older age, and travel• abuse of laxatives• problems with the colon and rectum

Bloating

Cause of bloating and flatulence

Bloating treatment: diet

The End